HEA 1032 Health Assessment Quiz
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Questions and Answers

Which cranial nerve is NOT responsible for the 8 cardinal fields of gaze?

  • CN 3 oculomotor
  • CN 4 trochlear
  • CN 7 facial (correct)
  • CN 6 abducens
  • What is the term for the ability of the pupil to change size in response to near and distant objects?

  • Consensual reaction
  • Nystagmus
  • Direct reaction
  • Accommodation (correct)
  • A client has a visual acuity of 20/400. What does this mean?

  • The client can see at 20 feet what a person with normal vision can see at 400 feet. (correct)
  • The client's vision is four times worse than normal vision.
  • The client's vision is four times better than normal vision.
  • The client can see at 400 feet what a person with normal vision can see at 20 feet.
  • While inspecting the eyelids, what term describes a localized collection of pus or infection on the eyelid?

    <p>Hordeolum (C)</p> Signup and view all the answers

    Which of the following is NOT a landmark of the tympanic membrane?

    <p>Incus (C)</p> Signup and view all the answers

    Which term describes the involuntary, rapid, rhythmic movement of the eyes?

    <p>Nystagmus (D)</p> Signup and view all the answers

    The Rhomberg test assesses which of the following?

    <p>Balance and proprioception (D)</p> Signup and view all the answers

    What is the term for the white part of the eye?

    <p>Sclera (B)</p> Signup and view all the answers

    During visual field assessment, what is being evaluated?

    <p>The ability to see in peripheral vision (A)</p> Signup and view all the answers

    Which cranial nerve is responsible for sense of smell?

    <p>CN I (Olfactory Nerve) (B)</p> Signup and view all the answers

    What is the term for the transparent layer covering the front of the eye?

    <p>Cornea (A)</p> Signup and view all the answers

    When assessing the external nose, what should the examiner check for?

    <p>Patency of the nasal passages (A)</p> Signup and view all the answers

    Which of these is NOT a part of the external structures of the eye?

    <p>Pupil (D)</p> Signup and view all the answers

    Which of the following is NOT a step in the assessment of the mouth?

    <p>Assessing the symmetry of the sternocleidomastoid muscles (B)</p> Signup and view all the answers

    When assessing the tongue, which of the following is NOT a finding to note?

    <p>Presence of a palpable lymph node (C)</p> Signup and view all the answers

    During the palpation of lymph nodes, which of the following is NOT a characteristic to note?

    <p>Color (B)</p> Signup and view all the answers

    What is the correct order of palpation for lymph nodes in the head and neck?

    <p>Preauricular, postauricular, occipital, tonsillar, submandibular, submental, superficial cervical, posterior cervical (D)</p> Signup and view all the answers

    Which of the following muscles is NOT assessed during the neck examination?

    <p>Pectoralis major (A)</p> Signup and view all the answers

    Which of these actions is NOT performed during the assessment of the neck?

    <p>Checking for crepitus in the temporomandibular joint (B)</p> Signup and view all the answers

    Which of the following is NOT a finding to be noted when inspecting the hard palate?

    <p>Size (A)</p> Signup and view all the answers

    The assessment of the mouth includes all of the following EXCEPT:

    <p>Checking for stridor (B)</p> Signup and view all the answers

    When examining the trachea, the examiner should place their fingers on either end of the clavicle and bring their second finger down to the trachea. Where should the second finger fall?

    <p>Between the first and second fingers (C)</p> Signup and view all the answers

    While examining the thyroid gland, what is the purpose of asking the client to sip on water?

    <p>To observe the movement of the thyroid gland (C)</p> Signup and view all the answers

    When performing the posterior approach to palpate the thyroid gland, which hand is used to curve the fingers around the sternomastoid muscle?

    <p>The right hand (D)</p> Signup and view all the answers

    What is the most awkward approach to palpate the thyroid gland?

    <p>Anterior approach (C)</p> Signup and view all the answers

    What is a possible reason why lymph nodes are more easily palpated in children?

    <p>Children have less developed muscle tissue than adults (C)</p> Signup and view all the answers

    What is a possible reason why the thyroid gland may be palpable during pregnancy?

    <p>Hormonal changes during pregnancy can cause the thyroid to enlarge slightly (B)</p> Signup and view all the answers

    In infants, the anterior fontanelle should be approximately how many centimeters in size?

    <p>2.5 cm (A)</p> Signup and view all the answers

    Which of the following conditions is NOT a possible finding in the examination of an elderly client?

    <p>Caput succedaneum (B)</p> Signup and view all the answers

    Match the following eye structures with their corresponding descriptions:

    <p>Conjunctiva = The membrane lining the inner surface of the eyelids and covering the sclera Sclera = The white outer layer of the eye Cornea = The transparent, dome-shaped layer that covers the front of the eye Pupil = The opening in the center of the iris that allows light to enter the eye</p> Signup and view all the answers

    Match the following terms related to eye assessment with their definitions:

    <p>Ptosis = Drooping of the upper eyelid Hordeolum = A localized collection of pus or infection on the eyelid Nystagmus = Involuntary, rapid, rhythmic movement(s) of the eye(s) Accommodation = The ability of the pupil to change size in response to near and distant objects</p> Signup and view all the answers

    Match the following cranial nerves with their respective functions related to eye movements:

    <p>Oculomotor (CN III) = Controls most eye movements, including pupillary constriction and accommodation Trochlear (CN IV) = Controls downward and inward movement of the eye Abducens (CN VI) = Controls lateral movement of the eye</p> Signup and view all the answers

    Match the following terms related to the inspection of the face with their descriptions:

    <p>Symmetry = The resemblance of the facial features on both sides of the face Features = The individual characteristics of the face, such as the nose, eyes, and lips Movement = The ability of the facial muscles to contract and relax, allowing for expressions Expression = The outward manifestation of a person's emotions, conveyed through facial muscles</p> Signup and view all the answers

    Flashcards

    Visual Acuity

    Ability to distinguish images clearly, measured by a Snellen Chart.

    Snellen Chart

    A chart used to test visual acuity from a distance of 20 feet.

    Tympanic Membrane

    The eardrum, critical to hearing and assessed with an otoscope.

    Auditory Acuity

    The ability to hear sounds, often tested by whispering words.

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    Rhomberg Test

    A test for balance that assesses vestibular function.

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    Trachea Examination

    Method to assess the trachea's position and symmetry.

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    Thyroid Gland Examination

    Assessment of the thyroid, usually not palpable; requires swallowing.

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    Posterior Approach to Thyroid

    Technique to examine thyroid from behind, checking movement upon swallowing.

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    Anterior Approach to Thyroid

    Technique to inspect thyroid from the front, feeling for enlargement.

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    Infant Skull Assessment

    Evaluate soft skull and head circumference in infants.

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    Lymph Nodes in Children

    Easily felt nodes in kids, typically mobile and nontender.

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    Thyroid in Pregnancy

    Thyroid gland may be palpable during pregnancy.

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    Senile Tremors

    Tremors in the elderly, often alongside curvature increases in the cervical spine.

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    HEENT Anatomy

    Refers to the anatomy of the head, eyes, ears, nose, and throat.

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    Physical Assessment of Head

    Involves inspecting and palpating the head's size, shape, and configuration.

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    Facial Symmetry

    Assessment of symmetry, features, movement, expression, and skin condition of the face.

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    PERRLA

    Abbreviation used in eye assessment: Pupils are Equal, Round, Reactive to Light, and Accommodation.

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    Eyeball Inspection

    Evaluates eyelids, conjunctiva, sclera, cornea, and pupil for abnormalities.

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    Extraocular Movements

    Assessment of eye movement controlled by cranial nerves during a gaze.

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    Visual Fields Test

    Measures how much a person can see at the periphery, assessing side vision.

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    Nystagmus

    Involuntary eye movement, often identified during eye assessments.

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    Mouth Inspection

    Assess lips, teeth, gums, buccal mucosa, and tongue for color, texture, and consistency.

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    Tongue Examination

    Check tongue for midline protrusion, lesions, and strength, as well as inspect Wharton’s ducts.

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    Palpate Lymph Nodes

    Gently feel lymph nodes with circular motion, noting size, consistency, and tenderness.

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    Neck Mobility Testing

    Assess neck movement by asking client to perform flexion, extension, lateral bending, and rotation.

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    Lymph Node Locations

    Know the major lymph nodes: preauricular, postauricular, occipital, tonsillar, submandibular, submental, superficial cervical, posterior cervical.

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    Inspect Uvula

    Assess the uvula for color, size, and any presence of lesions or exudate.

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    Buccal Mucosa Assessment

    Inspect the color and texture of the buccal mucosa, including Stenson’s ducts.

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    Tongue Strength Test

    Evaluate the strength of the tongue, especially the anterior part for taste.

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    Assessment of the Head

    Involves inspecting size, shape, configuration, and palpation for abnormalities.

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    Assessment of the Face

    Examines symmetry, features, movement, expressions, and skin condition of the face.

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    External Eye Structures

    Includes inspection of eyelids, conjunctiva, sclera, cornea, and pupil for lesions or abnormalities.

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    Study Notes

    HEA 1032 Health Assessment

    • Course focuses on physical assessment of the head, face, eyes, ears, nose, mouth, and throat (HEENT).
    • Presenter is Mrs. Keron Jones-Fraser, a PhD candidate, MSCN, BScN, and Certified Registered Nurse (RN).

    Objectives

    • Students will review briefly the anatomy and physiology of the HEENT.
    • Students will describe the physical assessment of the head, face, eyes, ears, nose and mouth.

    Motivational Activity

    • Spot 5 differences in two identical images (likely cartoons).

    Group Activity

    • Groups will prepare presentations assessing assigned body systems (head & face, eye, ear, nose, mouth & throat, neck & regional lymph nodes).
    • Presentations will include a short song, poem, or dub poetry.
    • Time allocated: 30 minutes.

    Assessment of the Head

    • Physical Assessment:
      • Inspect the head for size, shape, configuration, and involuntary movements.
      • Palpate the head.

    Assessment of the Face

    • Physical Assessment:
      • Inspect face symmetry, features, movement, expression, and skin condition.

    Assessment of the Eye

    • Anatomy: Diagram of the eye structure. (Diagram provided in the presentation) Includes labeled parts like sclera, cornea, iris, pupil, retina, optic nerve, etc.
    • External Structures:
      • Inspect eyelids for blinking ability, position (ptosis), and lesions (like stye).
      • Inspect conjunctiva (color, lesions).
      • Check sclera color (white, not red or yellow).
      • Inspect cornea (opacity, scratches).
      • Assess pupil size, shape, reaction to light and accommodation (use PERRLA, which means Pupils Equally Round Reactive to Light and Accommodation). Chart used for pupil size measurement (1-10mm).
    • General Areas of Inquiry:
      • Vision difficulty
      • Pain
      • Strabismus
      • Redness/swelling
      • Watering/discharge
      • History of ocular problems
      • Glaucoma
      • Use of glasses/contacts
      • Self-care behaviours
    • Test pupillary reaction to light (room should be dim): look for direct and consensual pupillary response. Test accommodation (near and distance). Observe convergence and pupillary contraction.
    • Extraocular movement: Evaluate eye movement with head remaining still (follow movement of object). Eight cardinal fields, controlled by cranial nerves 3, 4, and 6. Watch for nystagmus.
    • Visual Fields: Assess peripheral vision.
    • Visual Acuity: Determine the level of visual clarity (normal is 20/20, higher denominator indicates worse vision). Use a Snellen chart for testing.
    • Internal Structures: Visualize the eye's fundus using an ophthalmoscope.

    Assessment of the Ear

    • Structure (Diagram provided): Outer ear (pinna, external auditory canal, tympanic membrane), middle ear (ossicles: malleus, incus, stapes), inner ear (cochlea, semicircular canals)
    • Tympanic membrane landmarks: Identify handle and short process of the malleus, umbo, cone of light, pars flaccida, and pars tensa.
    • Auricle: Assess position, symmetry, and presence of lesions.
    • Canal: Inspect for drainage.
    • Auditory acuity: Gross hearing assessment using voice response tests (test one ear at a time, covering the other. Start with whisper). Use two-syllable words like "baseball".
    • Tuning fork tests: Tests like Weber and Rinne.

    Assessment of the Nose & Sinuses

    • External nose: Inspect for deviations in shape, size, color, flaring, and discharge. Check patency, and for sense of smell (olfactory nerve, CN I).
    • Frontal/Maxillary sinuses: Palpate for tenderness.

    Assessment of the Mouth

    • Anatomy (diagram provided): Labels of various mouth and throat structures such as lips, teeth, gums, buccal mucosa (inside cheek), tongue, uvula, hard palate, soft palate, tonsils, etc.
    • Physical Assessment:
      • Inspect lips (color, consistency).
      • Inspect teeth (number, color, condition, alignment).
      • Inspect gums (color, consistency).
      • Inspect buccal mucosa (color, consistency, Stenson's ducts).
      • Inspect tongue (color, moisture, size, texture, fasciculations or tremors).
      • Inspect hard and soft palate, uvula, and tonsils (color, size, exudate/lesions). Note any odor
      • Check for Wharton's ducts.

    Assessment of the Tongue

    • Physical Assessment
      • Check for midline protrusion.
      • Inspect ventral surface and frenulum.
      • Palpate lesions for induration (hardness).
      • Inspect Wharton's ducts and sides of the tongue.
      • Test tongue strength.
      • Check anterior tongue (taste).

    Neck & Regional Lymph Nodes

    • General:
      • Head should be held erect and still.
      • Note enlargement of glands/pulsation of veins.
      • Check for symmetrical muscle movement during active motion.
      • Ask client to perform movements (chin to chest, touch ear to shoulder, touch chin to shoulder, etc.).
    • Lymphatic Nodes: Use gentle circular motion to palpate nodes (preauricular, postauricular, occipital, tonsillar, submandibular, submental, superficial cervical, posterior cervical, deep cervical, supraclavicular). Note size, consistency, mobility, and tenderness. If enlarged or tender, assess area drained by the node.
    • Trachea: Place fingers on trachea and evaluate symmetry.
    • Thyroid gland (examination): Can be done from behind or in front of the client. It may not be palpable but note any possible swelling. Ask the patient to sip water, the thyroid should move in response.
    • Posterior & Anterior approach: Described methods for thyroid check including: posterior, and anterior approaches.

    Infants & Older Adults

    • Infant skulls: Soft skull, head circumference typically larger than chest circumference. Note for any caput or cephalhematoma. Check front and back fontanelles (approximately 2.5 and 1 cm).
    • Infant muscle development: Cradle the head and move it through the range of motion (ROM).
    • Older adults: Lymph nodes easier to palpate in infants than elderly. Thyroid may be palpable in pregnancy. Senile tremors and increased curvature of cervical spine are possible findings.

    References

    • Weber, J., & Kelley, J. (2018). Health assessment in nursing. Lippincott, Williams & Wilkins.

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    Description

    This quiz covers key concepts related to the physical assessment of the head, face, eyes, ears, nose, mouth, and throat (HEENT). Students will review anatomy and physiology, describe assessment techniques, and engage in activities to reinforce their knowledge. Join in for an interactive experience with group presentations and fun activities.

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